School Hygiene Research Articles

Enhancing Public Health: training an AI chatbot for complex tasks support

Abstract Background The evolution of Large Language Models (LLMs) such as GPT-4, Gemini, and Copilot has transformed the field of Natural Language Processing, demonstrating human-level capabilities and potential applications in Public Health. Here, we report on the training of a chatbot model based on GPT-4 designed to assist operators with relevant and complex public health tasks. Methods A scoping review of existing studies on the application of LLMs in Public Health settings was conducted to understand the landscape and identify gaps in their current implementations. We then proceeded to analyse the necessary skills and competencies required for public health professionals to adequately instruct the model on required tasks. Finally, we selected the Italian regulations and guidelines with the greatest relevance in the public health field to provide the knowledge base to the model. Results The review revealed no relevant documents on the use of LLMs in areas related to Public Health. Skills and competencies were retrieved from the Guidelines of the Italian Society of Hygiene for Public Health operators and used to instruct the model on how to address public health tasks. As for the knowledge base, we retrieved 25 documents regulating specific areas of the public health field, such as vaccinations, hygiene and safety at work, infection prevention, and school hygiene. Such documents were used to train the model, after formatting them appropriately. Conclusions Despite challenges with non-standardized and technically complex documentation, preliminary testing of our model has shown its versatility and utility in supporting daily public health operations. A validation phase is under definition and will involve a DELPHI process, in which products of the custom GPT model will be evaluated by a panel of public health operators to evaluate its performance in real-world settings, ensuring compliance with national health regulations. Key messages • Training a GPT-4-based chatbot to support complex tasks in Public Health, tailored by relevant national guidelines. • Our custom model, informed by public health guidelines, showed potential in preliminary tests.

How to rank schools of public health? The PHAR project

Abstract Background Since the shattering and abrupt withdrawal of several Ivy League universities from ranking systems in 2022, the debate on rankings has been raging in the academic world and beyond. Despite this, rankings have undeniable advantages and continue to be used on a daily basis by a variety of stakeholders. As a previous work has demonstrated that there is no ranking specifically designed for schools of public health, the aim of this project was to create one. Methods To create the Public Health Academic Ranking (PHAR), the InCites Benchmarking and Analytics™ software and the Web Of Science™ Core Collection database were employed. Bibliometric data on 26 schools of public health, from each continent, were collected between August and September 2022. Eleven research indicators and scores, covering four criteria (productivity, quality, accessibility for readers, international collaboration), for the period 2017-2021, were used. For some schools whose affiliation was not mentioned directly in the software, a specific methodology was designed and tested, with unique research queries applied to the database. Results The five top schools of the PHAR were: the London School of Hygiene and Tropical Medicine, the Public Health Foundation of India (PHFI), the Harvard T.H. Chan School of Public Health, the Swiss School of Public Health (SSPH+), and the Johns Hopkins Bloomberg School of Public Health. Conclusions The PHAR provides an international bibliometric ranking of schools of public health. As this is a pilot project, the results should be taken with caution and future improvements should be developed. Key messages • The PHAR is the first university ranking system specifically designed for schools of public health and focuses on the research field of this discipline. • The PHAR makes it possible to rank schools of public health with an unusual structure (such as the PHFI and the SSPH+), which are generally overlooked by traditional rankings.

Navigating the AI Wave: Overcoming Barriers and Unleashing the Potential of Artificial Intelligence in Transforming European Public Health

Abstract Artificial Intelligence (AI) is not just a future promise but an urgent necessity for modern public health. By providing invaluable insights into disease patterns, therapeutic interventions, and overall public health management, AI has the potential to revolutionise healthcare. To tackle essential public health functions effectively, harnessing AI must become a top priority. However, there is an urgent need for a cohesive strategy across Europe. Currently, varying readiness levels among European nations regarding AI adoption in health result in uneven progress across the continent. This disparity must be addressed to ensure all countries benefit equally from AI advancements. Recognising this, the World Health Organization European Regional Office launched a regional report on digital health in 2023. The report evaluated the integration of big data and advanced analytics, including AI, in health systems. Findings revealed that while 60% of Member States have a national data strategy, only 35% have a policy regulating big data and AI in health, and 38% lack both. This highlights a critical gap that must be filled urgently. Our upcoming session will address these challenges head-on. Organised to provide visionary insights, practical applications, and a landscape view of artificial intelligence in public health, the presentations will be followed by a roundtable discussion in which panellists will delve into practical challenges surrounding AI adoption. They will reflect on the profound impact AI could have on the future of European health systems and offer pragmatic and responsible steps forward, culminating in achievable recommendations for public health professionals. To enhance the session, we will utilise existing Generative AI tools to provide a real-time summary of the plenary and reinforce the call to action in alignment with panellists’ recommendations. This approach ensures that the session discusses the urgent need for AI in public health and actively demonstrates its practical applications. Moderators Natasha Azzopardi Muscat Director, Division of Country Health Policies and Systems, WHO Regional Office for Europe Dimitra Panteli Programme Manager/Senior Health Systems Analyst, European Observatory on Health Systems and Policies Facilitator Stefan Buttigieg Vice-President, EUPHA Digital health section Speakers/Panellists Martin McKee Professor of European Public Health, London School of Hygiene & Tropical Medicine, UK Katharina Ladewig Director, Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Germany Marco Marsella Director Digital, EU4Health and Health systems modernisation, Directorate-General for Health and Food Safety (DG SANTE), European Commission Keyrellous Adib Technical Officer Data Science and Digital Health, WHO Regional Office for Europe

Evaluating water, sanitation, and hygiene in schools of Bangladesh: progress toward SDG compliance

ABSTRACT The availability of safe water, sanitation, and hygiene (WASH) facilities in schools is essential for a healthy learning environment and achieving sustainable development goals (SDGs) 4 and 6. Despite its importance, comprehensive studies on drinking water quality, sanitation, and hygiene in schools are scarce. This study explicitly assessed the WASH services and gaps in 43 educational institutions, located in Tongi, Bangladesh, through field and laboratory investigations. Thirteen physicochemical and bacteriological parameters were analyzed, and water quality was classified using an Integrated Water Quality Index (IWQI). Hygiene and sanitation were evaluated through observations and data from school administrators on water sources, toilets, handwashing facilities, and solid waste management. Results showed that WASH services exceeded the national average, but all schools had dangerously high Escherichia coli levels (mean: 43.95 CFU/100 mL) in drinking water, posing health risks. Additionally, 89.72% of samples showed elevated manganese levels, 35% had high iron, and 41.86% had increased conductivity. About 35% of water was unsuitable for drinking based on IWQI. Schools lacked the capacity to monitor WASH quality, especially drinking water. A strategic framework for safe WASH facilities is recommended. The findings can lead the policymakers to prioritize the improvements in WASH facilities for attaining SDG 6.

The international cases of vaccinology education and its enlightenment to the discipline development in China

Vaccination is an effective public health measure to prevent and control vaccine-preventable diseases for individual and society. However, China currently confronts significant challenges, including a dearth of skilled professionals in the field of vaccination and disparities in the capacity for immunization services. This review introduced the experiences of four prime international vaccinology education models, including London School of Hygiene & Tropical Medicine, Johns Hopkins University, Leading International Vaccinology Education, and the Bill & Melinda Gates Foundation, in the aspect of personnel development, academic research and communication platforms establishment. It is supposed to give some insights and feasible suggestions on the establishment and advancement of vaccinology as a sub-discipline within high-level public health school in China, with the aim of development of a robust vaccinology education framework in China, which is essential for nurturing the next generation of public health leaders and practitioners for our country.

The level of implementation of water, sanitation, and hygiene (WASH) practices among the public basic schools in Ghana

ABSTRACT Water, sanitation and hygiene practices (WASH) have been a major challenge facing many basic schools in Ghana for many decades. The school authority have made a number of complaints to the Ghana government through the Ministry of Education in relation to the inadequate potable water, sanitation facilities and hygiene practices in basic schools which the government has remained silent on. The aim of this study was to assess the level of implementation of Water, sanitation and hygiene practices in basic schools in the Sunyani East Education Directorate. Both qualitative and quantitative data were collected using questionnaires and interviews. The results indicate that hygiene and sanitation facilities available in schools under study included urinals, toilets, handwashing materials and solid waste disposal facilities. It was revealed that wooden slap pit latrine toilet was present in all schools except Methodist school which has cemented slaps. There were absence of toilet rolls, tap facilities and hand washing soap in all schools visited. The pupils fetched water from neighbouring houses and used it. The study recommends that the Parent-Teacher Association, School Management Committee, District Education Directorate and Ghana Education Service should team up to provide these essential facilities to basic schools in Sunyani East.

Enhancing the usability of health data for inequalities research: a UK quality improvement project and code list curation.

Objective and ApproachPrimary care datasets provide a rich source of information for inequalities research; however, the value derived from these depends largely on the comprehensiveness of the code lists used by researchers. To date, no standardised code list for inequalities research has been developed. The aim of this project was to develop a comprehensive code list for groups of interest to inequalities research, namely: people with learning disabilities (LDs), people with severe mental illness (SMI), people from ethnic minority groups, and people who are transgender. Existing code lists were extracted from the Clinical Practice Research Datalink (CPRD) Bibliography (the largest research dataset in the UK), and four UK code list repositories: OpenCodelists, Health Data Research UK, University of Cambridge, and London School of Hygiene and Tropical Medicine. Comprehensive code lists were then curated through collation and removal of duplicates. Results16 code lists were identified for LDs, 18 for SMI, 16 for ethnicity, and 2 for transgender. From these, 661, 733, 346 and 68 unique codes were identified, respectively. Preliminary testing of the curated code lists, in a CPRD dataset, indicated that the number of individuals belonging to these groups was increased by 90% (compared to the original code list). Conclusions and ImplicationsOur findings suggest that the curated code lists improved data capture. These lists now need to be validated by healthcare specialists, before being made publicly available. The inclusion of code-specific definitions will enable international researchers to adapt the code lists to their medical systems.

Do school Water, Sanitation, and Hygiene facilities affect students' health status, attendance, and educational achievements? A qualitative study in Nepal.

Access to safe and sufficient drinking Water, Sanitation, and good Hygiene (WASH) facilities in schools play a crucial role in preventing students from numerous Neglected Tropical Diseases, improving the learning environment in schools, and creating resilient communities living in a healthy environment. This study aims to explore the impact of combining WASH facilities on students' health status, school attendance, and educational achievements. Four schools, two with improved and two without improved WASH facilities, were selected purposively from Dhanusha and Chitwan districts of Nepal. A total of 24 participants, 16 students, and eight teachers were also purposively selected based on the Theory of Data Saturation. The participants were interviewed face-to-face using study guidelines; Key Informants Interview for teachers and In-depth Interview for students. The data were audio recorded and analyzed thematically using Dedoose 9.0.17 qualitative data management and analysis software. School WASH facilities have a significant impact on students' health and well-being. Poor school-WASH facilities hindered students' school attendance, particularly for menstruating girls. School without separate toilets for girls, including menstruation hygiene facilities, lack of water and soap, sanitary pad, and secure toilet's door often have higher rates of absenteeism among girls. Poor teacher and students' relationships, students' low interest in education, household chores, and participation in social customs also contribute to students' absence from school and low educational performance. It is important to note that inadequate WASH facilities affect not only students, but also teachers in the same school. The lack of safe and sufficient drinking water, unimproved sanitation, and poor hygiene facilities were seen by students and teachers as reducing their health and well-being, school attendance, and academic performance. Thus, schools need prioritize and promote the provision of improved WASH facilities for the betterment of students' health, attendance, and educational proficiency.

The Legacy of Sir Ronald Ross: From Malaria Research to Multifaceted Achievements.

Sir Ronald Ross (13th May 1857 - 16th September 1932), a British doctor, was awarded the Nobel Prize in Physiology/Medicine in 1902 for research on the spread of malaria. This article highlights the multifaceted and significant scientific work by Ross. In 1897, he demonstrated that malaria is transmitted via mosquito bites and thatmalaria parasites existin the gastrointestinal tract of the mosquito. Ross elucidated the transmission cycle in mosquitoes and birds infected withPlasmodium. His 25-year career in the Indian Medical Service laid the foundation for his ground-breaking work in malaria. Besides medicine, Ross excelled in poetry, music, and mathematics. The London School of Hygiene & Tropical Medicine has a frieze dedicated to 23 people chosen for their accomplishments in the field of public health, one of whom is Sir Ronald Ross. His legacy lives on through various honors and institutions, like the Ross Institute.

Students’ knowledge and attitude towards school hygiene: A micro study in Murshidabad district

Students’ knowledge and attitude towards school hygiene: A micro study in Murshidabad district

Introduction to the special issue based on contributions from ‘A celebration of 50 Years of the Cox model in memory of Sir David Cox’, 10 November 2022, London School of Hygiene & Tropical Medicine

Introduction to the special issue based on contributions from ‘A celebration of 50 Years of the Cox model in memory of Sir David Cox’, 10 November 2022, London School of Hygiene & Tropical Medicine

Relationship between Knowledge, Information, and School Sanitation Facility with Menstrual Hygiene Practices Among Schoolgirls

Introduction: Menstrual hygiene practices are a form of self-care mainly related to mantaining the hygiene of reproductive organs specifically during menstruation. Based on previous research there are still various challenges for students to be able to maintain their menstrual hygiene in school, these challenges includes knowledge about menstruation, information, as well as school sanitation facility. Objective: The study aims to identify the relationship of knowledge, information, and school sanitation with menstrual hygiene practices in junior highschool students. Method: This study uses cross sectional carried out at one of Juniorhigh School in Wonokromo, Surabaya. The population in this study was a total of 45 girls, and the sample used 41 girls. The data analysis method is descriptive and analytical, using a chi-square test with (?=5% or 0.05) to identify the relationship of knowledge, information, and school sanitation facility with student menstrual hygiene practices. Result: The results of the study showed that 29 girls (71%) have good menstrual hygiene practices, and 12 other girls (29%) have poor menstrual hygiene practices. 32 girls (78%) stated that menstrual higiene information in the school was adequate and 9 girls (22%) said that the school's menstrual hygiene information was insufficient. Furthermore, 32 girls (78%) stated that school sanitation facilities were sufficient and could support the implementation of the Menstrual Hygiene Management (MHM), while the other 9 girls (22%) stated that the school hygiene facilities weren't sufficient for girls. The results of the bivariable analysis shows that there are meaningful relationships between knowledge, information and school sanitation facility with menstrual hygiene practices. Conclusion: This study shows the relationship between knowledge, information, and school sanitation facility with menstrual hygiene practices among schoolgirls.

Risk Factors Associated with Hygiene and Sanitation Practices in Public Secondary Schools in Kitale Municipality Trans Nzoia County, Kenya

Risk Factors Associated with Hygiene and Sanitation Practices in Public Secondary Schools in Kitale Municipality Trans Nzoia County, Kenya

Leadership Styles and School Performance: A Comparative Analysis of PEELI-Trained and Non-PEELI-Trained Head Teachers

This study explores the impact of PEELI training on head teachers in Multan, Punjab, Pakistan, focusing on their pivotal role in school performance. A sample of 416 participants, equally divided between trained and untrained head teachers, was selected through random sampling. Data was collected using questionnaires and checklists and analyzed using SPSS-11 software. This descriptive study found that PEELI training significantly enhances headteachers' awareness of children's right to education, barriers to accessing education, and effective resource utilization. Trained head teachers demonstratedbetter practices in using learning aids and maintaining hygienic school conditions, highlighting the importance of in-service training for educational leaders.

Water, Sanitation, and Hygiene (WASH) in Schools: A Catalyst for Upholding Human Rights to Water and Sanitation in Anápolis, Brazil

Ensuring access to water, sanitation, and hygiene (WASH) facilities, along with behavior change education in schools, is essential for fostering a conducive learning environment and promoting principles of inclusion, dignity, and equality. This study focuses on 12 primary schools in Anápolis, Brazil, with a total of 4394 students and 248 teachers. WASH assessments were conducted using a questionnaire, observations of water and sanitation facilities, and microbiological analysis. Between 2018 and 2020, the proportion of schools with safely managed drinking water increased from 42% to 92%. However, sanitation conditions in the schools were categorized as basic, with hygiene services rated as limited in 92% of the schools due to the absence of soap. While this study shows that Anápolis schools generally meet WASH guidelines for basic/advanced drinking water services, there is a crucial need for improvements in both hardware and software facilities to address sanitation and hygiene challenges.

75 years’ journey of malaria publications in English: what and where?

Malaria has inflicted serious morbidity and mortality across the globe. The major brunt of the disease has been on African, South-East Asian and South American countries. Proportionally, malaria has attracted global research priorities and this is evident from the number of publications related to malaria from across the globe, irrespective of its endemicity. However, formal and exhaustive analyses of these ‘malaria publications’ are rarely reported. The systematic review and secondary data analyses were done to retrieve information on what has been published on malaria, where is it published, and which countries are major contributors to malaria research.The study presents malaria publications from 1945 to 2020 retrieved using three databases: Web of Science™, Embase® and Scopus®. Exported data were examined to determine the number of publications over time, their subject areas, contributions from various countries/organizations, and top publishing journals.The total number of published records on malaria ranged from 90,282 to 112,698 (due to three different databases). Based on the number of publications, USA, UK, France, and India were identified as the top four countries. Malaria Journal, American Journal of Tropical Medicine & Hygiene, and PLoS One were the most preferred journals, whereas the University of London (Institutions other than LSHTM), the National Institute of Health, the London School of Hygiene and Tropical Medicine, and the University of Oxford appeared to be the top contributing organization.A disproportional contribution to malaria research was observed with non-malaria endemic countries making the largest contribution. Databases differed in their output format and needed standardization to make the outputs comparable across databases.

Zipime-Weka-Schista study protocol: a longitudinal cohort study and economic evaluation of an integrated home-based approach for genital multipathogen screening in women, including female genital schistosomiasis, human papillomavirus, Trichomonas and HIV in Zambia

IntroductionMultiplathogen home-based self-sampling offers an opportunity to increase access to screening and treatment in endemic settings with high coinfection prevalence of sexually transmitted (HIV, Trichomonas vaginalis (Tv), human papillomavirus (HPV))...

Impact evaluation of a cash-plus programme for children with disabilities in the Xiengkhouang Province in Lao PDR: study protocol for a non-randomised controlled trial

IntroductionMore than 170 countries have implemented disability-targeted social protection programmes, although few have been rigorously evaluated. Consequently, a non-randomised controlled trial is being conducted of a pilot ‘cash-plus’ programme implemented...

Incidence of Seromucous Otitis in Schools in Southern Algeria

Introduction: Seromucous otitis (SMO) is a very common pathology, affecting almost 50% of children. It is a benign condition, but should be investigated in adults for neoplasia of the nasopharynx. It is bilateral in 85% of cases, with an average age of 5 years. Although the evolution of this pathology is often favorable in children, with a tendency to spontaneous regression, in adulthood these ears can evolve into simple or dangerous chronic otitis. Aim: To assess the incidence of seromucous otitis in children in southern Algeria (Laghouat), where the hot season is longer than in temperate or cold regions, and to detect and treat chronic forms. Materials & Methods: This is a monocentric, prospective study involving all schoolchildren aged between 3 and 12, with no history of otitis (chronic otitis) or sensorineural hearing loss, over a 13- month period (October 2020 to October 2021). The diagnosis of sensorineural hearing loss is based on anamnesis and confirmed by clinical examination and functional hearing tests. Results: Of the 340 children examined over a one-year period, 28 presented with seromucous otitis, i.e. 8.2% of the sample size, with a peak in frequency between the ages of 4 and 6. There was also a slight male predominance. Promiscuity was the most frequent risk factor, observed in 64% of cases. Spontaneous regression of seromucous otitis was observed in 10 children (35.7%), and surgical treatment with a trans-tympanic aerator with or without adenoidectomy was instituted in 13 children. Conclusion: The natural evolution of SMO does not always lead to spontaneous regression, and many cases require early management and strict monitoring to prevent complications. It is therefore necessary to introduce screening as part of school hygiene in order to reduce the incidence of chronic otitis in adults.

Kazimierz Funk: Polish vitamins' discoverer.

Kazimierz Funk, born on February 23, 1884, in Warsaw, demonstrated an early inclination toward the field of human physiology. He charted his scientific trajectory within esteemed European scientific institutions, commencing at the age of 16 in Geneva, where he pursued studies in natural sciences. Subsequently, he continued his academic endeavors in Bern, culminating in the attainment of his doctorate in 1904. Following this, Funk relocated to Paris and secured a position at the Pasteur Institute. In France, his research concentrated on elucidating the role of trace elements in the human body. In 1906 he transitioned to Berlin, collaborating with Hermann Fisher (1852-1919) to investigate proteins and cancer processes. In 1910, Funk ventured to London, joining the Lister Institute, where he initiated research on beriberi disease. His investigations led to the isolation of a substance pivotal in treating the ailment, which he termed "vitamin" (derived from 'vita' meaning life and 'amine' indicating a nitrogen-containing compound). Despite four nominations for the Nobel Prize (in 1914, 1925, 1926, and 1946), Kazimierz Funk didn't receive the prestigious accolade. In 1925, at the urging of Dr. Ludwik Rajchman (1881-1965), the director of the National Institute of Hygiene, Funk assumed the directorship of the Biochemistry and Hygiene of Nutrition Branch at the National School of Hygiene. Under Funk's guidance, Poland became the third European country to produce insulin. Kazimierz Funk passed away on November 19, 1967, in New York City, at the age of 83. His significant contributions to the fields of biochemistry and nutrition endure as a testament to his enduring impact on scientific understanding. This proposal aims to condense and emphasise Kazimierz Funk's diverse scientific interests and the various scientific teams and sites he collaborated with, which ultimately led to his groundbreaking discover.